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Medscape Critical Care > Critical Issues COMMENTARY Transfusion Thresholds in the ICU: Is the Pendulum Swinging Back? Aaron B. Holley, MD November 03, 2016 Transfusion Thresholds 输血阈值 For many years, the findings of the Transfusion Requirements in Critical Care (TRICC) trial guided packed red blood cell (pRBC) administration in the intensive care unit (ICU).[1] This multicenter, randomized controlled trial (RCT) compared a conservative transfusion threshold (7.0 g/...
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Medscape Medical News > Oncology Old vs New: End of Debate on Blood Transfusion Storage Pam Harrison October 25, 2016 The most definitive evidence to date again confirms that in-hospital mortality rates do not differ for patients who receive the freshest blood during a transfusion compared to those who receive the oldest blood, leaving no room for further debate over the effect that storage length has on clinical outcomes, new research shows. 迄今为止最确切的证据证实,...
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Medscape Neurology > Viewpoints COMMENTARY Benefits and Risks of Craniectomy for Traumatic Intracranial Hypertension Laurie L. Barclay, MD October 06, 2016 Trial of Decompressive Craniectomy for Traumatic Intracranial Hypertension Hutchinson PJ, Kolias AG, Timofeev IS, et al N Engl J Med. 2016;375:1119-1130 Summary 总结 For patients with refractory traumatic intracranial hypertension, the impact of decompressive craniectomy on clinical outcomes is still a matter of deb...
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EDITORIAL IMPROVING FUNCTIONAL OUTCOMES FOLLOWING CRITICAL ILLNESS? The profound effects of critical illness on muscle strength, physical function and health related quality of life are well acknowledged [1,2]. Muscle weakness has been shown to occur early and rapidly in critical illness, and more rapidly still in those with multi-organ failure [3]. Similarly, follow-up studies have shown that the early weakness has prolonged and significant effects including reduced f...
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Editorial | October 05, 2016 Empirical Antifungal Therapy in Critically Ill Patients With Sepsis: Another Case of Less Is More in the ICU Trishul Siddharthan, Petros C. Karakousis, William Checkley JAMA. Published online October 05, 2016. doi:10.1001/jama.2016.13801 Candida species are the most common cause of invasive fungal infections, accounting for 70% to 90% of hospital cases.1,2 Although the overall US incidence of candidemia is low among nonneutropenic, criticall...
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Editorial | October 05, 2016 Oxygen in the ICU: Too Much of a Good Thing? Niall D. Ferguson JAMA. Published online October 05, 2016. doi:10.1001/jama.2016.13800 Oxygen gas was discovered and described in the 1770s by Scheele, Priestley, and Lavoisier and shortly thereafter its therapeutic potential for patients with respiratory illness was appreciated.1 Oxygen has become a mainstay of treatment for acutely ill patients, with emphasis frequently placed on the importance ...
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Editorial | October 03, 2016 Evaluating Glucocorticoids for Sepsis: Time to Change Course Sachin Yende, B. Taylor Thompson JAMA. Published online October 03, 2016. doi:10.1001/jama.2016.13904 For decades, researchers have tested glucocorticoids such as hydrocortisone, methylprednisolone, prednisolone, and dexamethasone, in varying doses, for the related conditions of pneumonia, sepsis, septic shock, and acute respiratory distress syndrome.1- 4 The overarching rationale ...
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Efficacy and safety of procalcitonin guidance in reducing the duration of antibiotic treatment in critically ill patients: a randomised, controlled, open-label trial. ICM Index Number: 23/052 Authors: de Jong E, van Oers JA, Beishuizen A et al. Reference: Lancet Infect Dis 2016;16:819-827. Trial registration number: NCT01139489. © Elsevier Ltd. ICM ABSTRACT Objective To assess the efficacy and safety of procalcitonin-guided antibiotic treatment discontinuation in ICU p...
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Effect of aspirin on development of ARDS in at-risk patients presenting to the emergency department: the LIPS-A randomized clinical trial. ICM Index Number: 23/044 Authors: Kor DJ, Carter RE, Park PK et al. Reference: JAMA 2016;315:2406-2414. Trial registration number: NCT01504867. © American Medical Association. ICM ABSTRACT Objective To evaluate the efficacy and safety of early aspirin administration for the prevention of acute respiratory distress syndrome (ARDS). I...
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Medscape Nephrology > Viewpoints  COMMENTARY Is Timing Really Everything With RRT? Tejas P. Desai, MD August 08, 2016 Early Dialysis in Acute Kidney Injury For years we have been told that early interventions result in better patient outcomes. Early cardiac catheterization results in more preserved myocardial function. Early antibiotic therapy can lead to better results in patients with pneumonia. Patients with signs of an ischemic stroke can recover more neurologic fun...
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